Validation of two parent-reported autism spectrum disorders screening tools M-CHAT-R and SCQ in Bamako, Mali.

AMALDEME, Malian association for mental deficiencies ASD, Autism spectrum disorders AUC, Area under the Curve CHU, University hospital centers CSCOM, Community health centers CSRef, District health centers DNS, National direction of health DRS, Regional direction of health DSM-V, Diagnostic and Statistical Manual of Mental Disorders FAPH, Faculty of Pharmacy FMOS, Faculty of medicine and odonto-stomatology ICD-10, International Statistical Classification of Diseases and Related Health Problems-10 LR+, Positive likelihood LR-, Negative likelihood M-CHAT-R M-CHAT-R, Modified checklist for autism in toddlers-Revised M-CHAT-R/F, Modified checklist for autism in toddlers-Revised/Follow up Mali NPV NPV, Negative predictive value PPV PPV, Positive predictive value SCQ SCQ, Social communication questionnaire USTTB, University of Sciences, Techniques and Technologies of Bamako

Journal

eNeurologicalSci
ISSN: 2405-6502
Titre abrégé: eNeurologicalSci
Pays: Netherlands
ID NLM: 101667077

Informations de publication

Date de publication:
Jun 2019
Historique:
received: 07 03 2019
accepted: 09 03 2019
entrez: 30 3 2019
pubmed: 30 3 2019
medline: 30 3 2019
Statut: epublish

Résumé

Early screening is crucial for early autism spectrum disorders (ASD) diagnosis and intervention. ASD screening tools have mostly been constructed based on the Western cultural context. We hypothesized that their use in Mali may require a prior validation. To validate the modified checklist for autism in toddlers-Revised (M-CHAT-R) and the social communication questionnaire (SCQ) in the Malian sociocultural context for ASD screening. We administered M-CHAT-R and SCQ in 947 toddlers aged 16-30 months old at the district and community health centers in Bamako and 120 patients (60 autistic and 60 age and sex matched controls) aged ≥4 years old at the psychiatry department in Bamako. Toddlers at moderate to high risk of ASD underwent M-CHAT-R/F and clinical evaluation by an ASD multidisciplinary team. M-CHAT-R and SCQ were evaluated for cultural appropriateness by Malian anthropologists. The sensitivity, specificity, PPV, NPV were determined for both M-CHAT-R and SCQ. Health professionals have been trained during ASD seminary on how to use M-CHAT-R and SCQ for ASD screening in Bamako. We found for the M-CHAT-R a sensitivity of 50%, a specificity of 100%, a PPV of 100% and a NPV of 87%. The SCQ had a sensitivity of 71%, a specificity of 72%, a PPV of 73% and a NPV of 70%. We have found four out of 20 items on the M-CHAT-R that were culturally inappropriate in the Malian context. M-CHAT-R and SCQ can be used for early autism screening in Mali. In the future, we plan to train a descent number of Malian physicians in chief and pediatricians at the district hospitals across the country to integrate the early ASD screening into the national health system. M-CHAT-R has a perfect specificity and SCQ a fair diagnostic accuracy for ASD in Mali.

Sections du résumé

BACKGROUND BACKGROUND
Early screening is crucial for early autism spectrum disorders (ASD) diagnosis and intervention. ASD screening tools have mostly been constructed based on the Western cultural context. We hypothesized that their use in Mali may require a prior validation.
OBJECTIVE OBJECTIVE
To validate the modified checklist for autism in toddlers-Revised (M-CHAT-R) and the social communication questionnaire (SCQ) in the Malian sociocultural context for ASD screening.
STUDY DESIGN METHODS
We administered M-CHAT-R and SCQ in 947 toddlers aged 16-30 months old at the district and community health centers in Bamako and 120 patients (60 autistic and 60 age and sex matched controls) aged ≥4 years old at the psychiatry department in Bamako. Toddlers at moderate to high risk of ASD underwent M-CHAT-R/F and clinical evaluation by an ASD multidisciplinary team. M-CHAT-R and SCQ were evaluated for cultural appropriateness by Malian anthropologists. The sensitivity, specificity, PPV, NPV were determined for both M-CHAT-R and SCQ. Health professionals have been trained during ASD seminary on how to use M-CHAT-R and SCQ for ASD screening in Bamako.
RESULTS RESULTS
We found for the M-CHAT-R a sensitivity of 50%, a specificity of 100%, a PPV of 100% and a NPV of 87%. The SCQ had a sensitivity of 71%, a specificity of 72%, a PPV of 73% and a NPV of 70%. We have found four out of 20 items on the M-CHAT-R that were culturally inappropriate in the Malian context.
DISCUSSION CONCLUSIONS
M-CHAT-R and SCQ can be used for early autism screening in Mali. In the future, we plan to train a descent number of Malian physicians in chief and pediatricians at the district hospitals across the country to integrate the early ASD screening into the national health system.
CONCLUSION CONCLUSIONS
M-CHAT-R has a perfect specificity and SCQ a fair diagnostic accuracy for ASD in Mali.

Identifiants

pubmed: 30923752
doi: 10.1016/j.ensci.2019.100188
pii: S2405-6502(19)30012-7
pii: 100188
pmc: PMC6423411
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100188

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Auteurs

Modibo Sangare (M)

Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.
West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.

Hamza B Toure (HB)

Faculty of Pharmacy, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.

Amadou Toure (A)

Department of Pediatrics, University Hospital Gabriel Toure, Bamako, Mali.

Adama Karembe (A)

Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.

Housseini Dolo (H)

Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.

Yaya I Coulibaly (YI)

Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.

Modibo Kouyate (M)

Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.

Kadiatou Traore (K)

Psychiatry Department, University Hospital Point G, Bamako, Mali.

Seidina A Diakité (SA)

Faculty of Pharmacy, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.
West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.

Souleymane Coulibaly (S)

Psychiatry Department, University Hospital Point G, Bamako, Mali.

Arouna Togora (A)

Psychiatry Department, University Hospital Point G, Bamako, Mali.

Cheick Oumar Guinto (CO)

Neurology Department, University Hospital Point G, Bamako, Mali.

Gordon A Awandare (GA)

West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.

Seydou Doumbia (S)

Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.

Mahamadou Diakite (M)

Faculty of Pharmacy, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali.
West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), College of Basic and Applied Sciences, University of Ghana, Legon, Accra, Ghana.

Daniel H Geschwind (DH)

Department of Neurology and Psychiatry, Center for Autism Research and Treatment, UCLA, Los Angeles, United States.

Classifications MeSH